CMS Price Transparency Data
Prosthetic fitting and training
Facility: Mercy Hospital Northwest Arkansas
Billing Code: 97761 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97761
- Insurance Median: $43
- Cash Discount Price: $70
- vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at Mercy Hospital Northwest Arkansas is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.06x the Medicare baseline. Located in 2710 South Rife Medical Lane, Rogers, AR.
Cash / Self-Pay
$70
Average discount available for prompt cash payment at this facility.
Insurance Median
$43
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$40.41
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $40.41 (100%)
Cash / Self-Pay: $70 (173%)
Insurance Median: $43 (106%)
Cash: $70 (173% of Medicare)
Ins. Median: $43 (106% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $40.41 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Input your details and click calculate to compare out-of-pocket costs.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Mercy Interfacility [20513] | $20 | 49% |
| Medicaid / KanCare | $35 - $52 | 87% |
| Aetna | $36 - $86 | 89% |
| American Health Advantage Of Mo Mcr [20264] | $36 | 89% |
| Blue Cross Blue Shield | $36 - $47 | 89% |
| Cherokee Nation Health Serv Contracted [320066] | $36 | 89% |
| Cigna | $36 - $164 | 89% |
| Cross Timbers Hospice [20098] | $36 | 89% |
| Dept Of Veteran Affairs Contracted [320106] | $36 | 89% |
| Elara Caring Aspire Hospice Contracted [320433] | $36 | 89% |
| Elara Caring Aspire Hospice [20433] | $36 | 89% |
| Globalhealth Contracted [320145] | $36 | 89% |
| Halo Hcr Inc Hospice Contracted [320432] | $36 | 89% |
| Halo Hcr Inc Hospice [20432] | $36 | 89% |
| Humana | $36 - $86 | 89% |
| Independent Health [20197] | $36 | 89% |
| Jordan Valley Senior Care Pace [20515] | $36 | 89% |
| Kindful Hospice Contracted [320434] | $36 | 89% |
| Kindful Hospice [20434] | $36 | 89% |
| Medical Associates Health [20444] | $36 | 89% |
| Medicare (plans) | $36 - $38 | 89% |
| Mercy Hospice Okc [20252] | $36 | 89% |
| Pace Of The Ozarks [20518] | $36 | 89% |
| Provider Partners Health Plans Contracted [320450] | $36 | 89% |
| Qual Choice Contracted [320325] | $36 | 89% |
| Spina Bifida Hlthcare Benefit [20506] | $36 | 89% |
| Tribute Health Plan Mcr [20338] | $36 | 89% |
| UnitedHealthcare | $36 - $157 | 89% |
| Valir Pace [20503] | $36 | 89% |
| Wellfirst Health Mcr [20443] | $36 | 89% |
| Tricare | $38 | 94% |
| St Johns Mercy Rehab Llc Contracted [320359] | $41 | 101% |
| St Johns Mercy Rehab Llc [20359] | $41 | 101% |
| Aither Health Contracted [320449] | $43 | 106% |
| Edison Health Solutions Contracted [320502] | $43 | 106% |
| Mercy Benefit Admin Contracted [320251] | $43 - $65 | 106% |
| Yuzu Health Contracted [320521] | $43 | 106% |
| Usable Contracted [320409] | $47 | 116% |
| Ambetter / Centene | $52 | 129% |
| Home State Health Plan Contracted [320187] | $52 | 129% |
| Novasys Contracted [320285] | $52 - $141 | 129% |
| 90 Degree Benefits Contracted [320436] | $54 | 134% |
| Show-Me Health Administrators Contracted [320483] | $54 | 134% |
| Health Choice Contracted [320166] | $58 | 144% |
| Auxiant Contracted [320462] | $65 - $70 | 161% |
| Ebms Contracted [320493] | $65 | 161% |
| Healthlink Contracted [320179] | $65 - $70 | 161% |
| Imagine 360 Contracted [320494] | $65 | 161% |
| Municipal Health Plan Contracted [320271] | $65 | 161% |
| Reflect Health Contracted [320492] | $65 | 161% |
| Benefit Management Contracted [320052] | $70 | 173% |
| Federal Medical Center Contracted [320127] | $70 | 173% |
| Insurance System Inc Contracted [320465] | $70 | 173% |
| Personify Health Contracted [320051] | $70 | 173% |
| Point C Contracted [320238] | $70 | 173% |
| Preferred Health Plan Contracted [320522] | $70 | 173% |
| Tri State Healthcare Coalition Contracted [320379] | $70 | 173% |
| Workers Comp [20426] | $70 | 173% |
| Private Health Care Systems Contracted [320320] | $79 | 195% |
| Private Health Care Systems [20320] | $79 | 195% |
| Ppo Plus Contracted [320310] | $81 | 200% |
| First Health Contracted [320128] | $83 | 205% |
| Employers Health Coalition Contracted [320116] | $85 | 210% |
| Healthscope Contracted [320182] | $86 | 213% |
| Multiplan Contracted [320270] | $92 | 228% |
| Multiplan [20270] | $92 | 228% |
| Qual Choice Contracted [320324] | $99 | 245% |
| United Medical Resources Contracted [320454] | $157 | 389% |